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CVS PHARMACY, INC.
CH01143AT Lynn Community Health, Inc.
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Covered Entity Details
Entity Name
Lynn Community Health, Inc.
Subdivision Name
William R Fallon Elementary School, School Based Health Center
Type
HRSA-Funded Health Center
340B ID
CH01143AT
Entity Address
100 Robinson St
Lynn, MA 01905-1816
Grant Number
H80CS00624
Participating Start Date
4/1/2020
Last Recertification Date
2/19/2025
Pharmacy Details
Pharmacy Name
CVS PHARMACY, INC.
Pharmacy Address
DBA: CVS/PHARMACY # 01204
509 EASTERN AVENUE
LYNN, MA 01902
Pharmacy Comments
Contract Details
Approval Date
3/6/2020
Contract Begin Date
4/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Kiame Mahaniah, Chief Executive Officer
(781) 596-2502 Ext: 2707
Contract Pharmacy Representative
CVS
Kimberly Hyep, Account Manager
(617) 599-9854
Signed By Date
1/8/2020
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